Individual
JEANETTE WIESKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
27240 HAGGERTY RD, SUITE E15, FARMINGTON HILLS, MI 48331-5716
(866) 991-0900
Mailing address
23771 RAVEN AVE, EASTPOINTE, MI 48021-3405
(866) 991-0900
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501005427
MI
Other
Enumeration date
08/26/2014
Last updated
08/26/2014
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